How many shoppable procedure prices are published for Childrens Hospital of Wisconsin?

Childrens Hospital of Wisconsin in Milwaukee, WI currently has 116 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

How do Childrens Hospital of Wisconsin's commercial prices compare to the fair BaseRate?

Across scored shoppable procedures, Childrens Hospital of Wisconsin's median negotiated commercial rate is 1.2× the regionally adjusted fair BaseRate benchmark.

Hospital Profile Children's Hospital Voluntary non-profit - Other 298 Beds · urban Updated: 2026-03-23

Childrens Hospital of Wisconsin

9000 W Wisconsin Ave, Milwaukee, WI 53226 · 116 Priced Procedures

CMS Overall Rating No CMS Rating

Above Fair Market · Negotiate

1.18×vs. Fair Market Price

Typical commercial prices here are +18% above the fair benchmark (1.18×) even after accounting for local nurse/doctor wages and patient complexity.

73/100 · Corroborated

73/100Self-Pay Cash Beats Insurance 88% of the Time

File Completeness66

Price Logic69

Peer Alignment60

Clean Billing74

Real Cash Discount100

High-Markup Tier

Balances commercial hospital prices against CMS clinical safety, infection control, and patient experience.

Behavioral Pricing FingerprintHigh Insurer Rate · Deep Cash Discount

Cash-Arbitrage Bifurcated Pricer

Childrens Hospital of Wisconsin maintains elevated commercial insurance contracts (1.18× Fair BaseRate) while offering direct self-pay cash discounts that beat commercial negotiated medians on 88% of procedures. High-deductible and uninsured patients should always request the self-pay cash rate prior to billing.

#38 of 99 in WI · 37th State Percentile#1,962 of 3,385 in U.S. · 57th National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Bottom-quartile procedures (Q25) price at 0.91× the peer BaseRate benchmark
Self-pay cash beats commercial insurance on 88% of shoppable procedures (99/100 Cash Honesty)
CMS clinical safety score (54/100 safety score) with 72% patient recommendation
IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (78.0% AGB cap)

Watchout

Where You Can Get Burned (Markup Traps)

Outpatient surgery & OR suites carry a 2.5× markup over Medicare rates
Commercial insurance median sits at 1.05× Fair BaseRate (2.0× Medicare), so insured patients should always compare the self-pay cash price before paying.
Upper-quartile procedures (Q75 1.22×) jump +16% above the median procedure ratio (Q50 1.05×)
Unnegotiated chargemaster list prices average 11.3× Medicare (27¢ true HCRIS cost per $1 gross)

Front-Door ShoppableElective / Imaging

2.0× Medicare

Pre-scheduled outpatient procedures where patients can comparison-shop.

Back-Door Captive & ER0.70× Divergence

1.4× Medicare

Emergency, inpatient DRG, lab, and specialty drug lines billed after admission.

Quantile Tail Spread+16% Upper Tail

Q25 0.91× · Q50 1.05× · Q75 1.22×

Detects median-gaming when upper-quartile codes spike above the p50 median.

Select any lens to inspect department markups, federal cost accounting, or insurer discounts.

Department & Integrity Multiples (vs. CMS Medicare Cost Anchor) Green ≤1.3× · Teal 1.3–1.8× · Amber 1.8–2.5× · Rose >2.5×

Front-Door Shoppable CareFront-Door Shoppable

2.0× MedicareGood

Outpatient Surgery & ORBack-Door Captive

2.5× MedicareFair

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

2.2× MedicareFair

Back-Door Captive ER VisitsBack-Door Captive

0.7× MedicareGood

Inpatient Lab & PathologyBack-Door Captive

3.5× MedicareElevated

Specialty & Infusion Drugs (J-Codes)Back-Door Captive

1.1× MedicareGood

Self-Pay Cash Honesty & 501(r)Integrity & Outcomes

88% Cash Edge · 99/100Good

CMS Clinical Safety & Star ValueIntegrity & Outcomes

3 CMS · 54/100Elevated

Procedure Prices at Childrens Hospital of Wisconsin

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 116 published procedures.

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Audit a Bill & 501(r) Cap ↓

Procedure & Billing Code	Self-Pay Cash	This Hospital	Fair BaseRate	vs. Fair
Sepsis treatment (inpatient stay) MS-DRG Code: `871`	—	$59,540	$19,087	3.1×
Hip or knee replacement (inpatient stay) MS-DRG Code: `470`	—	$57,216	$19,432	2.9×
Digestive disorders treatment (inpatient stay) MS-DRG Code: `392`	—	$23,678	$8,223	2.9×
Total knee replacement CPT Code: `27447`	—	$15,055	$13,523	1.1×
Total hip replacement CPT Code: `27130`	—	$13,958	$13,413	1.0×
Gallbladder removal (laparoscopic) CPT Code: `47562`	—	$11,838	$6,109	1.9×
Knee arthroscopy with meniscus repair CPT Code: `29881`	—	$8,894	$3,372	2.6×
Bunion correction surgery CPT Code: `28296`	—	$8,894	$3,446	2.6×
Inguinal hernia repair CPT Code: `49505`	—	$8,894	$3,629	2.5×
Breast lump removal CPT Code: `19120`	—	$8,894	$3,875	2.3×
Vaginal delivery (full package) CPT Code: `59400`	—	$8,450	$2,680	3.2×
C-section delivery (full package) CPT Code: `59510`	—	$8,450	$2,975	2.8×
Cataract surgery with lens implant CPT Code: `66984`	—	$7,870	$2,540	3.1×
Colonoscopy with biopsy CPT Code: `45380`	—	$7,870	$1,256	unverified
Upper endoscopy with biopsy CPT Code: `43239`	—	$6,159	$987	unverified
Colonoscopy (diagnostic) CPT Code: `45378`	—	$6,159	$981	unverified
MRI, brain (with and without contrast) CPT Code: `70553`	$3,587	$3,587	$511	7.0×
Sleep study (overnight, in lab) CPT Code: `95810`	$3,086	$3,086	$1,021	3.0×
MRI, lower back (no contrast) CPT Code: `72148`	$2,784	$2,784	$338	8.2×
Echocardiogram (heart ultrasound) CPT Code: `93306`	$2,582	$2,582	$583	4.4×
MRI, knee or other leg joint CPT Code: `73721`	$2,517	$2,517	$369	6.8×
Trauma team activation HCPCS Code: `G0390`	$2,295	$2,295	$1,453	1.6×
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$1,980	$1,980	$448	4.4×
MRI, brain (no contrast) CPT Code: `70551`	$1,858	$1,858	$343	5.4×
CT scan, head (with and without contrast) CPT Code: `70470`	$1,828	$1,828	$258	7.1×
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$1,849	$1,849	$303	6.1×
CT scan, chest (no contrast) CPT Code: `71250`	$1,460	$1,460	$167	8.7×
CT scan, pelvis CPT Code: `72192`	$1,396	$1,396	$163	8.6×
CT scan, head (with contrast) CPT Code: `70460`	$1,347	$1,347	$242	5.6×
Ultrasound, leg veins (duplex) CPT Code: `93970`	$1,345	$1,345	$272	4.9×
CT scan, lower back (lumbar spine) CPT Code: `72131`	$1,270	$1,270	$168	7.6×
CT scan, neck (cervical spine) CPT Code: `72125`	$1,270	$1,270	$169	7.5×
CT scan, head (no contrast) CPT Code: `70450`	$1,208	$1,208	$160	7.5×
Ultrasound, abdomen (complete) CPT Code: `76700`	$864	$864	$134	6.4×
CT scan, sinuses CPT Code: `70486`	$626	$626	$166	3.8×
Rabies immune globulin HCPCS Code: `90375`	$2,011	$602	$322	1.9×
Blood transfusion CPT Code: `36430`	$563	$563	$498	unverified
Ultrasound, pelvis CPT Code: `76856`	$492	$492	$130	3.8×
Ultrasound, abdomen (limited) CPT Code: `76705`	$420	$420	$126	3.3×
X-ray, lower back CPT Code: `72110`	$360	$360	$112	3.2×
Hepatitis B immune globulin HCPCS Code: `90371`	$166	$296	$151	2.0×
X-ray, chest (two views) CPT Code: `71046`	$239	$239	$93	2.6×
X-ray, shoulder CPT Code: `73030`	$235	$235	$92	2.6×
X-ray, foot CPT Code: `73630`	$235	$235	$92	2.6×
X-ray, hand CPT Code: `73130`	$235	$235	$93	2.5×
X-ray, ankle CPT Code: `73610`	$235	$235	$93	2.5×
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$162	$162	$64	2.5×
X-ray, hip CPT Code: `73502`	$182	$182	$93	2.0×
X-ray, pelvis CPT Code: `72170`	$204	$204	$110	1.9×
X-ray, neck (cervical spine) CPT Code: `72040`	$174	$174	$93	1.9×
X-ray, chest (single view) CPT Code: `71045`	$130	$130	$92	1.4×
Ultrasound, thyroid and neck CPT Code: `76536`	$117	$117	$132	0.9×
Hospital observation (per hour) HCPCS Code: `G0378`	$135	$135	$86	unverified
Office visit, established patient (30-39 min) CPT Code: `99214`	$286	$94	$123	0.8×
New patient office visit (30-44 min) CPT Code: `99203`	$270	$82	$110	0.7×
Breathing treatment (nebulizer) CPT Code: `94640`	$80	$80	$201	0.4×
Typhoid vaccine HCPCS Code: `90675`	$562	$562	$347	1.6×
Drug screening test HCPCS Code: `G0480`	$288	$288	$116	2.5×
Varicella (chickenpox) vaccine HCPCS Code: `90716`	$204	$204	$203	unverified
Pneumococcal vaccine HCPCS Code: `90732`	$145	$145	$140	unverified
Office visit, established patient (20-29 min) CPT Code: `99213`	$63	$66	$87	0.8×
Speech therapy (language evaluation) CPT Code: `92507`	$295	$65	$86	0.8×
Group therapy session CPT Code: `90853`	$67	$67	$100	0.7×
Psychotherapy session (60 minutes) CPT Code: `90837`	$76	$76	$181	0.4×
Psychiatric evaluation (first visit) CPT Code: `90791`	$76	$76	$185	0.4×
Family therapy session CPT Code: `90847`	$64	$64	$173	0.4×
Neurobehavioral status check CPT Code: `96116`	$76	$76	$231	0.3×
Speech therapy (group session) CPT Code: `92508`	$161	$33	$27	1.2×
Colorectal cancer screening (alternative) HCPCS Code: `G0145`	—	$29	$27	1.1×
Physical therapy (gait training) CPT Code: `97116`	$96	$34	$33	1.0×
Physical therapy (therapeutic exercise) CPT Code: `97110`	$93	$35	$35	1.0×
Occupational therapy (therapeutic activities) CPT Code: `97530`	$93	$36	$40	0.9×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$93	$34	$38	0.9×
Psychotherapy session (45 minutes) CPT Code: `90834`	$57	$57	$166	0.3×
Electrical stimulation therapy HCPCS Code: `G0283`	$93	$26	$14	1.9×
Prosthetic fitting and training CPT Code: `97761`	$93	$28	$45	0.6×
Orthotic fitting and training CPT Code: `97760`	$104	$29	$51	0.6×
Psychological testing evaluation CPT Code: `96136`	$38	$38	$128	0.3×
Blood test, calcium CPT Code: `82310`	$55	$6	$5	1.2×
Blood test, creatinine (kidney) CPT Code: `82565`	$50	$6	$5	1.2×
Blood test, clotting time (PTT) CPT Code: `85730`	$68	$7	$6	1.2×
Blood test, lipase CPT Code: `83690`	$87	$8	$7	1.1×
Blood test, average blood sugar (A1c) CPT Code: `83036`	$101	$11	$10	1.1×
Blood test, comprehensive metabolic panel CPT Code: `80053`	$162	$12	$11	1.1×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$119	$15	$14	1.1×
Blood test, ferritin (iron stores) CPT Code: `82728`	$106	$15	$14	1.1×
Hepatitis C antibody test CPT Code: `86803`	$120	$16	$15	1.1×
Blood test, PSA (prostate screen) CPT Code: `84153`	$60	$20	$19	1.1×
Prostate cancer screening (blood test) HCPCS Code: `G0103`	—	$21	$20	1.1×
Blood test, vitamin D CPT Code: `82306`	$284	$32	$31	1.0×
Blood test, basic metabolic panel CPT Code: `80048`	$117	$9	$9	1.0×
Blood test, liver function panel CPT Code: `80076`	$68	$9	$9	1.0×
Urinalysis (automated, with microscopy) CPT Code: `81001`	$47	$3	$3	1.0×
Blood test, amylase CPT Code: `82150`	$105	$7	$7	1.0×
Blood test, vitamin B12 CPT Code: `82607`	$130	$16	$16	1.0×
Psychological testing by technician CPT Code: `96138`	$38	$38	$395	0.1×
Blood test, glucose (blood sugar) CPT Code: `82947`	$49	$4	$4	1.0×
Blood test, magnesium CPT Code: `83735`	$42	$7	$7	1.0×
Blood test, potassium CPT Code: `84132`	$53	$5	$5	1.0×
Blood test, sodium CPT Code: `84295`	$68	$5	$5	1.0×
Blood test, thyroid (TSH) CPT Code: `84443`	$75	$18	$18	1.0×
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$45	$4	$4	1.0×
Blood test, hemoglobin CPT Code: `85018`	$33	$3	$3	1.0×
Blood test, complete blood count (CBC) CPT Code: `85025`	$87	$8	$8	1.0×
Blood test, clotting time (PT/INR) CPT Code: `85610`	$46	$5	$5	1.0×
Culture, blood CPT Code: `87040`	$184	$11	$11	1.0×
Culture, bacterial CPT Code: `87070`	$92	$9	$9	1.0×
Flu vaccine (high dose) HCPCS Code: `90656`	$37	$23	$25	0.9×
Physical therapy (manual therapy) CPT Code: `97140`	$93	$28	$34	0.8×
Extended office visit (prolonged) HCPCS Code: `G2212`	$63	$27	$33	0.8×
Occupational therapy (self-care training) CPT Code: `97535`	$93	$23	$38	0.6×
Hepatitis B vaccine HCPCS Code: `90744`	$59	$17	$37	0.5×
DTaP vaccine (diphtheria, tetanus, pertussis) HCPCS Code: `90700`	$74	$17	$39	0.4×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	$58	$17	$56	0.3×
MMR vaccine (measles, mumps, rubella) HCPCS Code: `90707`	$83	$17	$111	0.2×
Blood antibody screen CPT Code: `86850`	$77	$6	$46	0.1×

Showing top 25 high-impact procedures of 116 total

Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 78.0%

Audit a Bill or Quote at Childrens Hospital of Wisconsin (Zero PHI Required)

CMS CCN: 523300

CPT 871

Select Procedure to Audit:

Fair BaseRate™ $19,087

Medicare Rate $14,117

Self-Pay Cash Request Quote

Insurer Median $59,540

1. Amount on Your Bill or Quote ($) Pre-filled with Childrens Hospital of Wisconsin’s charged/list benchmark

2. Household Annual Income ($) Screened against 2026 HHS Federal Poverty Guidelines

3. Household Size (1–8) 2026 FPL: $15,650 + $5,500 per additional person

Step 1 · 501(r) Charity Care Check 501(r) AGB Cap: $111,459 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $111,459

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (78.0% of gross = $111,459).

Step 2 · Cash vs. Insurance Arbitrage Request Prompt-Pay Quote

Compare Prompt-Pay Cash Rate Against Remaining Deductible

Ask Childrens Hospital of Wisconsin's billing desk for their written 45 CFR § 180 discounted self-pay cash price and Good Faith Estimate under the No Surprises Act.

Step 3 · Fair BaseRate Target +$123,809 Above Fair BaseRate

Negotiate Toward $19,087 Fair BaseRate ($14,117 Medicare)

Your bill ($142,896) is $123,809 above the denoised Fair BaseRate ($19,087) and 10.1× the $14,117 Medicare rate.

1-Click Factual Dispute Summary: Copy a citation-backed benchmark memo (with CMS CCN, CPT code, Medicare reference, Fair BaseRate, and 26 U.S.C. § 501(r) calculations) to paste into patient-portal messages or billing appeals.

IRS Form 990 Schedule H & 26 U.S.C. § 501(r) 501(c)(3) Nonprofit Hospital

Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)

EIN: 390812532

Filing Period: 191912

Free Care Eligibility BenchmarkUp to 200% FPL100% charity write-off income threshold

Discounted Care EligibilityUp to 400% FPLSliding-scale & AGB billing cap tier

Charity Care Share of ExpensesSee Schedule HNet community financial assistance reported

26 U.S.C. § 501(r)(5) AGB Benchmark Method: lookback_commercial_median

Hospital-Specific CMS HCRIS Benchmark (78.0% of gross charges)

Under 26 U.S.C. § 501(r)(5), a tax-exempt hospital organization may not bill FAP-eligible patients more than Amounts Generally Billed (AGB) to individuals with insurance covering emergency or medically necessary care. Derived from this facility’s reported CMS HCRIS cost-to-charge & insurer allowance filings. Verify your exact Financial Assistance Policy (FAP) determination directly with the billing office.

Screen your household size, income, and itemized CPT codes against 2026 HHS Federal Poverty Guidelines: Calculate Your 501(r) Cap Above ↑

Care-Setting Arbitrage, Bilateral SVD Insurer Leverage & Regional Alternatives

How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings

Above-Benchmark Price Tier

2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Childrens Hospital of Wisconsin.

Price Index: 1.50× regional baseline

Quality: 54/100 CMS composite

Median Household Income$62,118U.S. Census ACS

Local Uninsured Share7.1%Regional ACS estimate

200% FPL (1 Person)$31,920Common free-care ceiling

400% FPL (Family of 4)$128,600Common AGB cap ceiling

45 CFR § 180 Primary-Source Lineage & Federal Verification VeriRate 73/100 · Corroborated CMS CCN 523300 EIN 390812532

Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings

MRF Portal Indexed (CMS_45_CFR_180_FILING.json) Verify on CMS Medicare.gov (CCN 523300) ↗ Verify IRS Form 990 (EIN 390812532) ↗ CMS HCRIS Cost Reports ↗

Published MRF FileCMS_45_CFR_180_FILING.json

Publication / Vintage2026-03-23

Validated Rate Rows8,090 (CMS v3.0.0)

File Integrity DigestVerified · CCN 523300

Safe-Harbor Data Corrections: Parsed directly from public 45 CFR § 180 hospital filings, CMS Care Compare, and CMS HCRIS cost reports. Hospital compliance officers may submit updated MRF URLs or rate tables for verification.

Submit MRF Update Correction Policy